Concussion Treatment: A Focus on Omega-3 Fatty Acids

There are very few treatments for concussion beyond rest and symptom management. Other than acetaminophen for headaches, there are no drugs formally recommended for the treatment of concussion.1,2 Nevertheless, several medications and supplements are currently being tested for their potential usefulness in concussion. Among these, omega-3 fatty acids are among the most intriguing. Various animal studies suggest that omega-3 fatty acids could be helpful in reducing the effects of concussion on the brain. In fact, clinical trials are currently underway that will help determine whether omega-3 fatty acids play a role in the treatment of concussion.

Omega-3 fatty acids

Omega-3 fatty acids are polyunsaturated fats with a very particular chemical structure. The “three” in omega-3 means that there is a double bond on the third carbon atom from the end. More importantly, omega-3 fatty acids have a number of important effects on health including roles in cancer, inflammation, and cardiovascular disease.3,4Three of the more important omega-3 fatty acids are linoleic acid, docosahexanoic acid (DHA), and eicosapentaenoic acid (EPA). Omega-3 fatty acids are found in fish oils, eggs, and certain plant oils, such as flaxseed oil. They are also available in supplement form.

Omega-3 fatty acids and brain trauma

Omega-3 fatty acids, especially DHA, are very important for brain cell structure and function.5 DHA improves brain cell function by reducing oxidative stress and inflammation. It also supports the cell membrane of brain cells, particularly at the synapse.6 The body can produce DHA to a very limited extent, but most DHA and other omega-3 fatty acids enter the body through the diet. If someone does not consume enough omega-3 fatty acids, this could lead to neurological dysfunction.6

Omega-3 fatty acid supplementation

Much of what we know about omega-3 fatty acids and concussion has come from studies in animals. When animals are subjected to brain trauma, it creates characteristic changes in the brain and affects behavior. Researchers use experimental trauma to study ways to improve function after injury or to minimize the effects of the trauma.

In one series of experiments, researchers fed one group of rats a DHA dietary supplement while another group simply ate a normal diet. After four weeks, both groups suffered an experimental brain injury. The rats that received DHA experienced fewer trauma-related changes in the brain than rats fed a normal diet.7Rats given DHA performed better on tests of learning and memory than animals without supplementation.

In other words, DHA supplementation at least partially protected rats from the effects of traumatic brain injury.7

Other researchers showed that EPA and DHA given after mild brain injury reduced concussion damage in the brain at the microscopic level.8,9 Specifically, DHA was able to reduce the levels of APP in axons, which is a marker of brain trauma.

Omega-3 fatty acid deficiency

Conversely, when mice were deprived of DHA, they did worse on behavioral tests and had larger brain lesions after traumatic brain injury compared to mice fed a normal diet.10 Thus, DHA deficiency can increase the damage caused by brain trauma, at least in mice.

Omega-3 fatty acid studies in humans

Despite the relatively low cost and wide availability of omega-3 fatty acids, few human studies have directly examined the effects of omega-3 fatty acids in the treatment of concussion or mild traumatic brain injury. While clinical trials are ongoing, we still do not know what effect, if any, that EPA or DHA will have in humans with concussion. So far, the evidence in humans is limited but promising. For example, physicians published a case study in which a person with severe traumatic brain injury (much worse than concussion) was given large amounts of omega-3 fatty acids (EPA and DHA) and seemed to do well without any adverse events from the supplements.11 Unfortunately, it is still too early to say definitively whether omega-3 fatty acids are protective or useful in treating concussion; however, clinical trials will hopefully shed light on this intriguing possibility.